There are many issues that face today's drugs activist.  Most, if not all of us get involved in the field of activism and peer advocacy by being directly confronted with the kinds of issues, or overwhelming needs of our own local communities. Often, we begin our activism by working to improve the very services we use, or need.  However, it doesn't take long for us to realise that there are many larger issues that affect more than just our day to day lives; they affect our futures and our societies as well. Below are videos chosen to provide some background to what we consider to be the top 10 issues that confront our community today (in no particular order). This will hopefully give some insight into the kind of issues our community -and EuroNPUD and its sister networks - have become involved in, in order to affect change and promote humane progress in the area of drug policy. Some of these videos are made by the community of people who use drugs. NOTE: As of 2018, EuroNPUD will be looking towards the issues facing migrants  in the European Union. Any organisation concerned about drug use and health as it affects migrants is encouraged to get in touch.


The Top  10 Issues Facing Drug User Activists


No. 10 Drug Consumption Rooms

The first officially approved DCR opened in Berne, Switzerland, in 1986 but today there are over ninety in Europe (in Switzerland, the Netherlands, Germany, Spain, Norway, Luxemburg Sydney Australia, and, more recently, Denmark, France, and Vancouver, Canada. These sites have been established for a range of reasons, with differing rationales reflecting local and national drug-related concerns and priorities. Issues such as  drug overdose, prevalence of blood borne viruses (HIV, Hepatitis B (HBV) and C (HCV)) and the overall health and welfare of people who use/inject drugs and the communities they live and use drugs in.  

The few videos below look at why it is so important for all of us in cities and towns, to have DCR provision and look at their growing and impressive evidence base. Scaling up DCR provision in countries across Europe is an important activism point for our community as is getting involved in the development of DCRs across Europe  From preventing the closure of a DCR (like in Greece) or getting a new one open (like in Paris), or providing new insights into DCRs, the meaningful engagement of people who use drugs in both DCR development and policy, is not just important work in our community but the issue itself is at the top of important and lifesaving issues for people who use drugs.



No. 9 Naloxone & Overdose Prevention

 Drug overdose continues to be the main cause of death among regular opiate users and heroin or its metabolites are present in the majority of reported fatal overdoses. Naloxone is a lifesaving overdose reversal drug that rapidly counteracts the effects of opioids and is currently the standard treatment for overdose.

In Europe, overdose prevention programmes that include the distribution of naloxone date back to the 1990s. EMCDDA published a comprehensive review about this topic:

Naloxone initiatives are critical and the scaling up of programmes and peer led interventions are crucial in order to save the lives of people who use opiate drugs. Naloxone has been an area of wide campaigning and EuroNPUD will continue to campaign strongly on this issue over the coming years. The drug using community are adament that every single opiate user, their friends and their loved ones should have access to Naloxone and be equippped with the skills in how to use it. Currently the nasal spray is being rolled out in many EU countries, which remains a simpler option for many. Watch a range of Naloxone videos from Europe and elsewhere, here.



No. 8 Blood Borne Viruses

Drug overdose continues to be the main cause of death among problem drug users and heroin or its metabolites are present in theprevention programmes that include the distribution of naloxone date back to the 1990s.

Read more: This week, EMCDDA published a comprehensive review about this topic, always comprehensive review about this topicand topic

majority of reported fatal overdoses. Naloxone is a lifesaving overdose reversal drug that rapidly counteracts the effects of opioids and is currently the standard treatment for overdose. In Europe, overdose lifesaving overdose reversal drug that rapidly counteracts the effects of opioids and is currently the standard treatment for overdose. Naloxone is a big issue for activists and a lifesaver for our community.


Views on Hepatitis C in Europe today -a film by Swedish Drug Users Union

HIV, Hepatitis C and Injecting Drug Use, a film by Exchange Supplies



No. 7 Stigma & Discrimination


For the community of people who use drugs, stigma and discrimination are regularly the number one issue on the list in terms of the biggest issue facing drug users today. The stigma of 'addiction' is in itself a subject laden with labels and judgements and one that many drug users reject because of it. The stigmatising labels of 'junky' etc see all people who use drugs as conforming to a certain stereotype (thieving, dangerous, lying) and often applies this label for the lifetime of the person.

In doing so, such stigmatisation actively discriminates against PWUDs and further impedes the 'recovery' that society claims it wants to promote. However, for people who use drugs, this discrimination goes right to the very heart of the issue around why our community must organise itself.

Find out more about the issue in these interesting videos. 



No. 6 Opiate Substitution Treatment (OST)


Drug treatment is an area that has brought many people who use drugs into the field of activism due to the enormous impact drug treatment can have on a drug users life and that of their family. The last two decades has seen a big rise in the number of drug and alcohol services available for, predominately opiate users but many of these services have been punitive, moralising, are difficult to access or remain in. The effects of prohibition has created a massive growth in the treatment and pharmaceutical industries and PWUDs face an inordinate amount of 'management' as they transit through such services.  People who use drugs have an extremely important role to play in the development, monitoring, review and evolution of drug treatment and related services, if we want to have services that are responsive, humane and innovative today and in the future.. We need to look at different treatment choices, the meaningful involvement of PWUDs in services, and more appealing and accessible drug treatment, particularly for new migrants as they settle and traverse the EU.



No. 5 Harm Reduction


Harm Reduction stands as both an ideology and a practice and it has been an incredibly important issue for community of people who use drugs. Not only has it given our community the tools and the knowledge to be able to use drugs more safely, it has also provided a language and a platform from which to present much wider issues to society.  Europe has often been at the forefront of the world's understanding and provision of harm reduction and its associated services however, the last few years has seen harm reduction services being targeted by cash strapped governments and international donors. Harm reduction provisions, as these videos will show, is a vital community and health service and it continues to evolve as new drugs need new messages. Harm reduction must continue in the future to remain the backbone of evidenced based drug policy and it will always remain a vital issue for the drug using community.



No. 4 Prohibition Vs Regulation


Prohibition has had a devastating impact on the lives of millions of people, criminalising, marginalising, and discriminating generation after generation. Almost every activity drug user activists are involved with today, is literally trying to rectify the huge damage and fallout from bad drug policies enacted through prohibition. The many deaths from overdose, violence, poverty and isolation, the problem of BBVs and the health issues of drug users, the lives ruined by imprisonment for months, years and decades and the knock on effect of illegal drug use on families and communities...all a result of a system that is propped up by billions of (ill spent) dollars, and politicians who are increasingly defending the indefensible. The justification for criminal prohibition is that the danger from certain drugs is so grave, the only way to protect the public, is to ban them outright.

If a ban could be rendered completely effective, this questionable premise might be tested, however eighty years of history have shown the various methods of suppression to be so ineffective that the global drug market, has actually grown progressively, especially since the end of World War II and "illicit drugs" are now everywhere purer, cheaper and more abundant than ever. The issue of decriminalisation and regulation is not only gaining more ground across the world as the hopeless reality of prohibition is reflected back to every government on earth, but we now see it implemented in various forms by a few brave, forward thinking governments. The videos below look at some of the issues around prohibition, including 10 years on in Portugal after they decided to implement decriminalisation over 10 years ago.



No. 3 Women & Girls


Women and girls who are directly affected by drugs and drug use, face huge problems across the world. Digging beneath the surface of the issue reveals a gender bias across the board and upsetting levels of violence. Overall, many statistics show that men use illicit drugs more than women. However, differences in drug use between men and women are complex and depend upon the specific substance used and the user’s age, social group, educational level and geographical location. Women who use drugs have been at the sharp end of the world's drug war, yet the problems they face are often hidden below the surface. The fear of losing children or being labelled a 'bad mother' or worse, are firmly entrenched views within most societies. The  huge rise in women being incarcerated in many countries shows that, although women and girls are usually minor links in the drug supply chain, they suffer a disproportionate burden in the application of criminal law. Globally, women are incarcerated for drug offences, mostly non-violent, more than for any other crime. The films below give an insight into some of the issues women face.  


No. 2 Prison, Incarceration & Enforced Treatment

The massive rise in the numbers of people who use drugs filling up the world's prisons is deeply disturbing. The depth and breadth of issues that face drug user activists is enormous and there are some areas that have received less attention in the past. Prison and enforced rehabilitation centres are two of these areas. The American system of private prisons in slowly heading to Europe, as is Super Max Prisons, that mean over 1000 prisoners housed in one prison, which usually means less staff able to manage such numbers, which leads to people being locked in their cells for up to 23 hours a day, no staff available to accompany prisoners to medical or hospital appointments or run classes and groups. There does need to be more collaboration between prisoner led groups and organisations and the drug user movement; many of our issues coincide and strength is always in numbers; lets work together to improve European standards and policies in prisons. The rise of enforced detox and rehab globally in countries like Burma, Guatemala, Philippines and others is very disturbing trend.

It is creating a hidden (though often accepted by an ill-informed or ignorant society)  financially motivated and sometimes religiously driven network of locked houses, bootcamps and sheds where drug users are often kidnapped from the street, bundled into cars without knowing where they are going, and locked inside a house that poses as a clinic or rehabilitation centre. Women are locked in rooms with no access to anything or anyone and are vulnerable to being raped or harassed. Many captives are chained to beds, and forced to detox without any medical help and their families either forced or pressured to pay a lot of money for something masquerading as treatment. The massive industry of rehabilitation centres for PWUDs is growing globally and PWUDs are victims of a largely unregulated network that promises much and usually delivers very little, or worse, to people who are at their most vulnerable. An issue that needs a lot more attention and investigation.



No. 1 Meaningful Involvement


While facing severe marginalization and discrimination that has resulted in epidemics of HIV and hepatitis C, millions of people who use illegal drugs remain largely unrepresented when decisions are made about how to respond to health and other concernsEffective democracy ensures people affected by decisions have a voice in how these decisions are reached. This principle is so central to our culture that we often do not question it. So why then do we debate the idea of including drug users in decision-making when neglecting to do so would be alien in most other areas of society?89 Despite popular prejudice to the contrary, people who use drugs have proven, through their active involvement in the response to HIV and HCV, that they can organise themselves and make valuable contributions to their communities. People who use drugs can play a wide range of roles; as contributors, speakers, implementers, experts, and participants in decision-making bodies. They must be involved at all levels, in the issues that affect their lives. Nevertheless, recognition of the life circumstances of many people who use drugs, and because of the stigma and often hostility and suspicion they face, special efforts are and will be necessary to make such involvement possible -and meaningful.